National Provider Identifier [NPI]: |
1053653220 |
Last Name Of The Provider |
BURNS |
First Name Of The Provider |
AMBER |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
PA-C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
501 20TH ST |
Street Address 2 Of The Provider |
STE 203 |
City Of The Provider |
KNOXVILLE |
Zip Code Of The Provider |
379161809 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
344 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
166594 |
Total Medicare Allowed Amount |
19946 |
Total Medicare Payment Amount |
15361.81 |
Total Medicare Standardized Payment Amount |
18045.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
61 |
Number Of Medicare Beneficiaries With Drug Services |
26 |
Total Drug Submitted ChargeAmount |
6026 |
Total Drug Medicare AllowedAmount |
4972.04 |
Total Drug Medicare PaymentAmount |
3868.88 |
Total Drug Medicare Standardized Payment Amount |
3868.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
42 |
Number Of Medical Services |
283 |
Number Of Medicare Beneficiaries With Medical Services |
142 |
Total Medical Submitted Charge Amount |
160568 |
Total Medical Medicare Allowed Amount |
14973.96 |
Total Medical Medicare Payment Amount |
11492.93 |
Total Medical Medicare Standardized Payment Amount |
14177.01 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
41 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
114 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
28 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
20 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
20 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.2051 |